Stenosis of the Spine: What is it and Does it Require Surgery?
Stenosis of the spine, or spinal stenosis, is a narrowing of the space within your spinal canal. This most often occurs in the lower back and neck; it can put pressure on the spinal cord and/or nerves that travel through your spine.
Spinal stenosis is most commonly caused by osteoarthritis, which is referred to as “wear and tear” arthritis. With osteoarthritis, the top layer of cartilage between joints deteriorates or breaks down so there is less cushion between the bones. Cartilage allows joints to move smoothly against one another and absorbs the shock of movement.
As the cartilage breaks down, someone suffering from osteoarthritis might experience swelling, pain and issues associated with movement of the joint. Cartilage cells are not able to regenerate. So over time, bones may start to chip or break down, or develop growths called bone spurs. Bone spurs that develop on the vertebrae can extend into the spinal canal, which can pinch spinal cord and/or nerves in the spine.
Herniated discs also are a common cause of spinal stenosis.
Symptoms of spinal stenosis
Some people with spinal stenosis may not have symptoms. Others may experience a variety of symptoms, including:
- Pain in the lower back
- Numbness or tingling in the leg or foot
- Weakness in the leg or foot
- Neck pain
- Numbness or tingling in the arm or hand
- Weakness or clumsiness in the arm or hand
- Problems with balance
- Loss of function in hands
These symptoms can worsen over time.
Treatment for spinal stenosis
Most people with spinal stenosis don’t need surgery. Your doctor likely will first recommend at-home remedies and non-surgical treatments to try to relieve pain. Those might include:
- Applying heat and/or cold
- Exercises to strengthen muscles
- Over-the-counter pain relievers that include ibuprofen, naproxen or acetaminophen
- Physical therapy
- Epidural steroid injections
If those options don’t provide relief, your doctor may recommend surgery. Surgery involves removing portions of bone, ligament or disc that are pinching spinal cord and/or nerves.
Surgical options include:
- Laminectomy. Removing a portion of the vertebra (and possibly some ligaments and bone spurs) to make room for the spinal cord and/or nerves to relieve symptoms.
- Foraminotomy. Removing a small part of the foramen, which is the bony opening in the vertebrae where the nerve roots exit in order to provide more space for the nerve roots.
- Discectomy. Removing disc bulges or herniations that are causing pressure on the spinal cord and/or nerves in order to make more room for them to breathe.
- Spinal fusion. This procedure is generally performed if you have spinal instability and it is a last resort. Spinal fusion surgery permanently fuses two vertebrae together. The healing process takes six months to one year.
If you are suffering from neck or back pain, schedule an appointment today with Dr. Charles Yu.